CLINICAL-EPIDEMIOLOGICAL PROGRAM OF STUDYING PSYCHOSOCIAL RISK FACTORS IN CARDIOLOGICAL PRACTICE IN PATIENTS WITH ARTERIAL HYPERTENSION AND ISCHEMIC HEART DISEASE: FIRST RESULTS OF A MULTICENTER STUDY IN RUSSIA

摘要

Background. More than 10 years passed since conduction of the first clinical-epidemiological study of prevalence of psychosocial risk factors (PSRF) in patients with arterial hypertension (AH) an/or ischemic heart disease in Russian Federation. Purpose: to assess current prevalence of PSRF in patients with AH/CHD and their relationship with traditional risk factors. Materials and methods. Patients with verified AH and/or CHD aged = 55 years were included into this cross-sectional study in 30 cities of Russia representing 7 federal districts according to the following procedure. In each city we selected 2-5 federal clinics - providers of primary medical care; in each of these clinics we at random invited 2-5 physicians to take part in this study. Each of these physicians for 1-2 days included 10 consecutive patients with AH and/or CHD. Information collected from patients comprised social demographic and clinical characteristics, risk factors, adherence to therapy; Hospital Anxiety and Depression Scale (HADS) was applied for detection of symptoms of anxiety and depression. Obtained information was used for analysis of prevalence of cardiovascular risk factors and their association with symptoms of depression and anxiety in a frame- work of Pearson linear and Kendall rank correlation analysis. Results. Symptoms of anxiety of various severity (HADS-A = 7) were detected in 42.2% of patients with AH and/or CHD, in 25.5% they were clinically significant (HADS-A = 11). Symptoms of depression of various severity (HADS-D = 7) were detected in 42.5% of patients with AH and/or CHD, in 16.3% they were clinically significant (HADS-D = 11). We also observed several significant associations of symptoms of depression and anxiety with traditional cardiovascular risk factors: low level of physical activity, elevated systolic and diastolic arterial pressure, level of total cholesterol, abdominal obesity; some unhealthy nutritional habits. Conclusions. Prevalence of symptoms of anxiety and depression was found to be high among ambulatory patients with AH and/or CHD. However, in this study it was lower compared with that reported by previous studies in Russia.